The team debriefing was vital for the NGO group to plan ahead. This team
was a vital field link in determining medical needs in the area. There assessment of
the situation, identification of needs and report allowed for decisions based on facts in
the field. Medical problems and needs were defined based on above information.
Medical needs for the future would be nursing care of posttraumatic injuries,
dressings of wounds, detection and management of infections. Exposure related
illnesses like Respiratory infections are on the rise needing basic clinical diagnosis
and simple antibiotics. Poor sanitation is leading to potential diarrhea though only a
couple of patients reported with this illness. Psychosocial problems are to be expected
in the future with people loosing family members as well as everything they have
ever owned. As a consequence of this trauma, physical and mental, immediate
problems of shock, tension, anxiety, panic, relief and disorientation may be seen. This
in turn will lead to a disabling post disaster grief, apathy, unresponsiveness, guilt and
the post trauma stress disorder. A team from NIMHANS (National Institute of Mental
Health and Neurosciences) was already activated and this teams feedback has added
to evidence of their need to intervene in the next few weeks. They have left to assess
and coordinate these special post trauma problems by training local personnel in
dealing with such situations. Malnutrition and other specific nutritional deficiencies
may be the future especially for women and children among the displaced population
if food supplies/distribution are not streamlined. Rehabilitation may be needed up to a
period of three years. In the past week there have been approximately 6000 doctors in
the Kutch area alone and volunteers are becoming a burden to an already stretched
infrastructure. The need today is not to blindly go in now but to wait till the specific
need arises. Medical Supplies are in plenty with excellent neighbors, roads and airport
facilities. This too has become a burden with people painstakingly sitting down to
make inventories of all supplies. We may have a situation where the mass of
volunteers and supplies has actually been detrimental to the progress of disaster relief
from rescue to the intermediate phase of temporary shelters, provision of food and
drinking water, sanitation apart from medical team support at this stage. In the next
few weeks these observations will change and needs may differ.